How HS Can Affect Men Differently

While hidradenitis suppurativa (HS) is a rare condition that affects about 4 out of every 100 people, it is more common in women than in men. According to some research, for every 1 man with HS, there are 2 to 5 women who have it. While doctors and scientists agree on the rate of HS between men and women, they do not yet understand why this is.¹

Learning more about how HS affects men differently and what scientists think are the reasons for these differences can give you a better understanding of life with the condition.

Hidradenitis suppurativa in men

First, it is important to understand that both men and women can get HS, and both can have moderate or severe cases. HS often develops around the teenage years in both young men and women.^2,3

Next, both men and women experience the same HS symptoms, including painful, hard, or pus-filled bumps under the skin, called lesions. These lesions often start as comedones (clogged skin pores). In both men and women, these lesions often form in the armpit area. This is most likely because the armpit area creates a perfect storm for HS: the skin contains hair follicles, and it frequently touches or rubs together.^1,3

Another similarity is treatment, which is not usually different for men and women. HS treatment can include drugs applied directly to the skin, such as corticosteroids, antibiotics, anti-inflammatories, or other prescription hormonal or biologic therapies. Surgeries or laser hair removal are also used to treat and prevent severe symptoms.^2,3

There is also no known difference in risk factors (things that make you more likely to have a condition or to have more severe symptoms). Both men and women are more likely to get HS if it runs in the family. Smoking and being overweight are also associated with HS in both men and women and can lead to worse symptoms. Quitting smoking and losing weight are recommended for all people with HS.²

How HS affects men differently

Doctors and researchers have found some important differences between HS in men and women. Although men and women can both experience mild to severe HS, men may be more likely to have more severe HS, in particular, HS-associated acne. Some researchers have found that women with HS are more likely to have a family history of the condition.¹

Also, men and women may not experience the same types of symptoms on the same parts of the body. As noted above, both men and women can experience HS lesions in the armpits. However, according to some studies, men experience more (or more severe) lesions on the buttocks, while women experience more (or more severe) lesions in the breast and groin areas.²

Hormones are another difference. Men and women’s bodies make the same types of hormones, including testosterone and estrogen. However, the amount of these hormones and what they do in the body are different. Hormones can also change how a condition affects the body and which treatments will work best. For example, hormonal differences between men and women may explain why some women have HS flare-ups around their menstrual periods.⁴

Finally, some men are able to take advantage of an HS treatment that cannot be prescribed to all women. Although oral finasteride (Propecia) has had success as a treatment for HS with good results in both men and women, it should not be given to women who are pregnant or could become pregnant because it can cause birth defects.⁵

Why these differences are important

One thing doctors and researchers can agree on is that there is so much more we need to learn about HS. One of the big reasons that scientists look for HS differences in men and women is that these differences can be keys to understanding where HS comes from, how to manage symptoms, and, importantly, preventing HS in the future.